CERTIFICATO MEDICO

CERTIFICATO MEDICO
Si certifica
che la paziente______________ nata/o a ______________il ____________
domiciliata/o a (provincia e indirizzo), sulla base degli elementi clinico–anamnestici rilevati, non
presenta allo stato attuale segni clinici tali da controindicare la pratica di attività ginnico-motoria
non-competitiva, compatibile con l’età, purché adeguatamente seguita/o dai istruttori professionali.
La disciplina ginnico-motoria è : attività motoria ludico ginnica in palestra e sauna.
MEDICAL CERTIFICATE
I certify that the patient (family name, name)______________ born in ______________on
____________ and resident of (state and address)__________________, on the basis of his/her
clinical-anamnestic characteristics, does not at the present time show any clinical signs that
contraindicate the practice of non-competitive gymnastic-motor activities, which are compatible
with his/her age, as long as he/she is appropriately guided by professional instructors. Gymnasticmotor discipline includes: gymnastic, motory, and sport activities in the gymnasium and sauna.
Date_______________
Doctor’s signature and stamp_______________